This document discusses the use of optically stimulated luminescence dosimeters (OSLDs) for medical dosimetry applications in radiation therapy and diagnostic radiology. Specifically, it summarizes research conducted by a collaboration between Oklahoma State University and other institutions on: 1) Using OSLDs for high-precision dosimetry in radiation therapy with photons and electrons; 2) Determining dose profiles inside phantoms using OSLD strips in X-ray computed tomography; and 3) Investigating the performance of OSLDs for dosimetry of therapeutic proton beams, including measurements in air and along proton ranges. The results demonstrate the capability of OSLDs for medical dosimetry and their potential for one-dimensional dose

1. Medical applications of optically stimulated luminescence dosimeters (OSLDs)
E.G. Yukihara a,*, P.B.R. Gasparian a
, G.O. Sawakuchi b
, C. Ruan c
, S. Ahmad d
, C. Kalavagunta c
, W.J. Clouse c
,
N. Sahoo b
, U. Titt b
a
Physics Department, Oklahoma State University, 145 Physical Sciences II, Stillwater, OK 74078, USA
b
Department of Radiation Physics, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, USA
c
Department of Radiological Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, USA
d
Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, USA
a r t i c l e i n f o
Article history:
Received 5 August 2009
Received in revised form
14 December 2009
Accepted 28 December 2009
Keywords:
Optically stimulated luminescence
Radiotherapy
Proton therapy
Medical dosimetry
Diagnostic radiology
a b s t r a c t
This work presents an overview of the advances in the application of optically stimulated luminescence
(OSL) to dosimetry in diagnostic radiology and radiation therapy achieved by the Oklahoma State
University group in collaboration with the University of Oklahoma Health Sciences Center and the
University of Texas M. D. Anderson Cancer Center. This overview discusses: (a) the development and
demonstration of readout protocols for high-precision dosimetry in radiation therapy using high-energy
photons and electrons; (b) the determination of dose profiles inside acrylic phantom in computed
tomography; and (c) the performance of OSL dosimeters for dosimetry of proton therapeutic beams,
including point measurements in air and along pristine and spread-out Bragg peaks. Our results
demonstrate the capability of performing high-precision measurements (experimental standard devi-
ation of 0.7%) in radiotherapy and show the possibility of performing one-dimensional dose mapping in
X-ray computed tomography and proton beams. In the case of protons, our results show that OSL
dosimeters are energy independent for protons with energies above 100 MeV, but a reduction in effi-
ciency is observed at the end of the proton range.
Ó 2010 Elsevier Ltd. All rights reserved.
1. Introduction
There is an increasing interest in the use of the optically stim-
ulated luminescence (OSL) technique for applications in medical
dosimetry. This interest is evident by the number of articles pub-
lished in specialized journals such as Medical Physics (Andersen
et al., 2009a,b; Chen et al., 2009; Gaza et al., 2005; Jursinic, 2007;
Reft, 2009; Schembri and Heijmen, 2007; Viamonte et al., 2008;
Yukihara et al., 2008), Physics in Medicine and Biology (Yukihara
et al., 2005, 2009), British Journal of Radiology (Aznar et al., 2005),
Radiotherapy and Oncology (Meeks et al., 2002), and Radiographics
(Bauhs et al., 2007). The articles cited above investigated the use of
OSL dosimeters (OSLDs) in external beam radiation therapy using
photons, electrons, and protons, X-ray computed tomography (CT),
mammography, and brachytherapy. A few review papers (Akselrod
et al., 2007; Pradhan et al., 2008; Yukihara and McKeever, 2008)
and a book chapter (Cygler and Yukihara, 2009) are also available.
Nevertheless, the number of articles is still small and the lack of
characterization of OSLDs and established protocols remains the
main obstacle for OSLD users in medical dosimetry.
In this work we present an overview of the advances in the
application of the OSL technique to dosimetry in diagnostic
radiology and radiation therapy achieved by the Oklahoma State
University group in collaboration with the University of Okla-
homa Health Sciences Center (OUHSC) and the University of
Texas M. D. Anderson Cancer Center (UTMDACC). This overview
presents: (a) the development and demonstration of readout
protocols for high-precision dosimetry in radiation therapy; (b)
the determination of dose profiles inside acrylic phantom in
X-ray CT; and (c) investigations on the performance of OSLDs for
dosimetry of therapeutic proton beams, including measurements
in air and along pristine and spread-out Bragg peaks. This paper
does not aim at presenting a comprehensive and detailed
investigation of OSLDs applied to these different areas of medical
dosimetry, but mainly to give a glimpse of the potential of the
OSL technique in this field. A few aspects have been already
discussed in previously published work and are summarized here
for completeness. Other aspects, particularly on measurement of
dose profiles in X-ray CT and proton therapy, are briefly dis-
cussed; more complete results are currently in preparation and
will be published elsewhere.
* Corresponding author. Tel.: þ1 405 744 5051; fax: þ1 405 744 6811.
E-mail address: eduardo.yukihara@okstate.edu (E.G. Yukihara).
Contents lists available at ScienceDirect
Radiation Measurements
journal homepage: www.elsevier.com/locate/radmeas
1350-4487/$ – see front matter Ó 2010 Elsevier Ltd. All rights reserved.
doi:10.1016/j.radmeas.2009.12.034
Radiation Measurements 45 (2010) 658–662

2. 2. Methodology
2.1. Conventional radiation therapy
The methodology for dosimetry of high-energy photons and
electrons used in our studies in conventional radiation therapy has
been presented in Yukihara et al. (2008, 2005). Because our meth-
odology differs significantly from other authors (e.g., Jursinic, 2007;
Viamonte et al., 2008), particularly with respect to the OSL reader
and readout protocol, we summarize its main aspects in this paper.
The OSLDs used in this study are 7 mm in diameter by 0.3 mm
thickness,preparedfromOSLDtapes manufactured byLandauer, Inc.
and consist of Al2O3:C powder embedded in plastic films (Bøtter-
Jensen et al., 2003). The material is the same used in Landauer’s
LuxelÔ and InLightÔ dosimetry systems. Before irradiation the
OSLDs were bleached overnight using yellow light from fluorescent
lamps filtered bya Schott GG-495 filter (Schott AG, Mainz,Germany).
In our studies we avoided using the plastic cases used in commercial
systems because of possible air gaps and uncertainties in the
dosimeter position; instead we used the bare detectors packaged in
black electric tape only for protection against light exposure.
The OSL was read using a Risø TL/OSL-DA-15 reader (Risø
National Laboratory, Røskilde, Denmark) equipped with green LEDs
operated in continuous-wave stimulation mode and a photo-
multiplier tube (PMT) model 9235QB (Electron Tubes Ltd.,
Uxbridge, UK). To block the stimulation light, the light detected by
the PMT was filtered by Hoya U-340 (Hoya Corporation, Tokyo,
Japan) (7.5 mm thickness) optical filters. An additional Schott WG-
360 (2 mm thickness) filter was used to remove the UV emission
band of Al2O3:C. With this filter combination, the detected OSL
signal was primarily from the main luminescence center of Al2O3:C,
a broad band centered at around 420 nm (Yukihara and McKeever,
2006). The background signal (mostly dark counts and light
leakage) was estimated from the PMT count rate at the end of the
600 s stimulation time and properly subtracted. The OSL signal S
was defined as the total area under the OSL curve (600 s of stim-
ulation). The readout and analysis protocol use the OSL signal SR
after a reference dose DR and a calibration curve (S/SR versus known
doses) to account for variations in the dosimeter’s mass and
sensitivity (Yukihara et al., 2005). Irradiations with photons and
electrons were carried out in a water phantom using a Varian 21 EX
linear accelerator at the OUHSC (Yukihara et al., 2008, 2005).
Additional measurements on the stability of the OSL signal were
carried out in this study using a commercial InLightÔ microStar
reader (Perks et al., 2008) for comparison with other studies
(Jursinic, 2007; Reft, 2009). Bare OSLDs were irradiated using
a 90
Sr/90
Y source (0.90 Gy dose) and mounted in InLightÔ holders
for readout at different periods after irradiation. Dosimeters irra-
diated more than a year ago (5 Gy dose) were also read to monitor
the reader stability and decrease of the OSL signal due to the
multiple OSL readouts. Although we used the high-dose stimula-
tion mode of the microStarÔ reader, which uses weak stimulation
power and should decrease the OSL signal by 0.05% per readout
(Jursinic, 2007), each detector was read multiple times to improve
the statistics and therefore the resultant decrease in the OSL signal
was considered. The OSL signal was considered to be the raw
(uncorrected) counts indicated by the microStarÔ reader. The
background due to dark counts was <0.02% of the OSL signal. In
between readouts, the dosimeter’s slides were kept in the InLightÔ
case inside a black plastic bag at room temperature.
2.2. Determination of dose profiles in X-ray CT
Dose profiles measurements in X-ray CT were determined using
OSLD strips 150 mm long, 4–5 mm wide, and 0.3 mm thick, also
prepared from OSLD tapes manufactured by Landauer Inc. The
strips were placed in the center and periphery positions of CT head
and body dosimetry phantoms (U.S. Food and Drug Administration
(FDA), 1984) and irradiated using X-ray CT beams using a GE
Lightspeed VCT scanner at the OUHSC. The OSLD strips were read
using a custom-built pulsed OSL reader coupled to a motorized
translational stage, which translates the strip below an aperture of
dimensions 3 mm  1.5 mm. The OSLD strips were read in 0.25 mm
step sizes with an integration time of 0.1 s per position. See Yuki-
hara et al. (2009) for more details.
2.3. Proton therapy
OSLDs prepared as described in Section 2.1 with dimensions 4
mm  4 mm  0.3 mm (thickness) were irradiated with protons at
the Proton Therapy Center, Houston (PTCH) of the UTMDACC using
passive scattering and scanning beams (Gillin et al., 2010; Sahoo
et al., 2008) with nominal proton energies ranging from 100 to 250
MeV. For the irradiations in the passive scattering beam the OSLDs
were placed at different water equivalent depths in a solid water
phantom to provide data in the pristine and spread-out Bragg
peaks. The field size at isocenter was 10 cm  10 cm, which had
flatness of less than 3% in the central region of the field. The OSLDs
were also read as described in Section 2.1. The OSL efficiency was
defined as the ratio of the absorbed dose to water determined using
OSLDs (using a calibration curve as a function of 60
Co gamma dose
to water) to the dose to water determined using ADCL (Accredited
Dosimetry Calibration Laboratory) calibrated ionization chambers
from the PTCH (corrections factors for the beam quality were
applied).
For the irradiations in the scanning beam, OSLD strips were
positioned on the patient’s table at the isocenter plane in air and
irradiated with a single 221.8 MeV mono-energetic proton pencil
beam at 0 deg gantry angle. The readouts of the OSLD strips were
carried out using the same OSLD strip reader and parameters
described in Section 2.2, except that an aperture 1 mm in diameter
was used when scanning the strip. The lateral profile was also
measured using a small size ionization chamber (type 31014, PTW-
Freiburg, Freiburg, Germany) for comparison.
3. Results and discussion
3.1. Conventional radiation therapy
Previous investigations from our group demonstrated that
OSLDs can achieve a precision of w0.7% (single readout) in high-
energy photon and electron beams using the Risø reader and
appropriate readout and analysis protocol (Yukihara et al., 2008,
2005). Measurements of depth dose curves for various photon and
electron energies indicated an agreement with ionization chamber
within Æ1% or a distance-to-agreement of the order of 0.5–1 mm in
the high-dose gradient regions (Yukihara et al., 2008). Influencing
factors such as beam quality, dose rate, field size, and irradiation
temperature did not affect the OSLD response by more than 1%
(Yukihara et al., 2008).
In spite of these promising results mentioned above, one
problem that has been identified by other researchers is the rela-
tively high fading (>5%) in the first 5–15 min following irradiation
(Jursinic, 2007; Reft, 2009). We investigated the fading using irra-
diated OSLDs mounted in InLightÔ slides, and read using the
microStarÔ reader after different intervals of time. Fig. 1 shows the
OSL signal for OSLDs freshly irradiated and OSLDs irradiated more
than a year ago. In addition tothe fast fading in the first minutes after
irradiation, a continuous decrease in the signal was observed, sug-
gesting that time elapsed since irradiation may need to be taken into
E.G. Yukihara et al. / Radiation Measurements 45 (2010) 658–662 659

3. consideration. Nevertheless, it should be noticed that the x-axis is in
logarithmic scale, i.e. the rate of fading decreases as time passes.
This signal instability has so far been observed only using the
microStarÔ reader, which detects the OSL intensity for a short time
interval (w1 s) and is equivalent to recording the initial OSL
intensity. The fast decay in the initial minutes after irradiation is
likely associated with competition by shallow traps, which is
expected to affect the initial intensity more than the total OSL area.
Future investigations should focus on determining if such fading is
also observed in the OSL signal monitored for long stimulation
periods (total OSL area), which should not be affected by shallow
traps.
3.2. X-ray CT
We also tested the potential of using OSLD strips to measure
dose profiles in X-ray CT beams. Because of the high effective
atomic number of Al2O3:C (Zeff ¼ 11.3) and its resultant over-
response to low energy photons, we calibrated the OSL system for
the X-ray energies used in the CT irradiations. It has been demon-
strated that differences as high as 16% can be observed in the
calibration factors as a function of X-ray tube potential and irradi-
ation position in the CT phantom (center or periphery) (Yukihara
et al., 2009). Therefore, we used a calibration factor for each irra-
diation condition, obtained by comparing the OSLD strip’s signal
with the doses measured with a small 0.3 cm3
ionization chamber.
The results showed that the dose profiles obtained using OSLD
strips agreed with the ionization chamber measurements over the
entire length of measurement, once the energy response is taken
into account. Moreover, the CT dose index CTDI100 (AAPM, 2008)
calculated using the OSLD strip agreed with the values obtained
using a 100-mm CT pencil chamber (Yukihara et al., 2009).
3.3. Proton therapy
Proton therapy is another area in which the factors influencing
the OSLD’s response have not been completely determined.
Previous investigations in the context of space dosimetry observed
a decrease in OSL efficiency for increasing linear energy transfer
(LET) of the radiation, but the data for therapeutic proton energies
(LET in water w0.4–5 keV/mm) obtained in the past presented high
uncertainties (Sawakuchi et al., 2008). For this reason, new irradi-
ations were carried out at the PTCH with a wider range of energies
and at different water equivalent depths.
Irradiations with protons in air (at the entrance of the phantom)
and at different water equivalent depths were performed to
investigate the OSLD’s energy response and performance for
measurements in the pristine and spread-out Bragg peaks. Exper-
iments on the proton energy response indicated small energy
dependence for protons with nominal energy above 100 MeV. Fig. 2
shows an example of three experiments for the determination of
the proton energy response, obtained with OSLDs irradiated in air
(at the entrance of the phantom) with pristine beams. The first
experiment involved irradiations with eight proton energies. The
variation in the response was less than 1% and the OSL efficiency
was within 1.5% from the value 0.934 predicted by Sawakuchi et al.
(2008). The second and third experiments showed larger devia-
tions, but still within Æ2%. Experiments are currently being
undertaken to clarify this issue.
Irradiations at different water equivalent depths showed
a reduction in OSL efficiency at the end of the proton range, as
observed in Fig. 3. At the end of the proton range, the OSLDs are
exposed to protons of lower energy (and higher LET) than the
protons at the entrance of the phantom; for example, for 250 MeV
protons the average LET increases from w0.435 keV/mm (in water)
at the entrance to w2 keV/mm at 27.8 cm depth. The increase in LET
is associated with saturation of the OSL signal along the particle
track, causing a reduction in the OSL efficiency (Sawakuchi et al.,
2008). For the same residual proton ranges, the reduction in effi-
ciency was less pronounced for proton beams of high nominal
energy. The agreement between the OSLD and the ionization
chamber measurements along the Bragg curve seems to be worse
than in the case of LiF:Mg,Ti TLDs irradiated with 200 MeV proton
beam (Bilski et al., 1997) or CaF2:Tm irradiated with 155 MeV
proton beam (Moyers and Nelson, 2009).
The reduction in OSL efficiency was also less pronounced for
measurements at the spread-out Bragg peak, as shown in Fig. 4,
10
1
10
2
10
3
10
4
10
5
0.86
0.88
0.90
0.92
0.94
0.96
0.98
1.00
1.02
)dezilamron(langisLSOevitaleR
Time Elapsed (min)
Freshly irradiated OSLDs
OSLDs irradiated >1 year ago
Fig. 1. Relative OSL signal as a function of elapsed time since irradiation for freshly
irradiated detectors (0.9 Gy); detectors irradiated more than a year before (5 Gy) were
also read to monitor for reader stability and account for decrease in the OSL signal due
to multiple readouts (the results are presented in the same x-axis as the freshly irra-
diated detectors). The OSLDs were mounted in InLightÔ slides and measured using
a microStarÔ reader; each data point corresponds to the average of three detectors
(each one read three times) and the error bars are the experimental standard deviation
for the three detectors. The data was normalized to the first point after irradiation.
90 120 150 180 210 240 270
0.92
0.93
0.94
0.95
0.96
0.97
0.98
ycneiciffE
Proton Energy (MeV)
1
st
Experiment
2
nd
Experiment
3
rd
Experiment
Fig. 2. Relative OSL efficiency as a function of proton energy for three experiments
(irradiations) at the PTCH. The data is based on Al2O3:C OSLDs 4 mm  4 mm  0.3 mm
thickness readout using a Risø TL/OSL reader with Hoya U-340 and Schott WG-360
filters in front of the PMT. The values were determined using the total OSL signal (600 s
of stimulation); each data point corresponds to the mean value of five detectors and
the error bars are the combined standard uncertainty.
E.G. Yukihara et al. / Radiation Measurements 45 (2010) 658–662660

4. although still observed at the end of the proton range. In this case,
the energy is deposited by protons with a very broad energy
distribution and the average LET is relatively low for most of the
measurement depths.
We also investigated the possibility of measuring lateral profiles
of single proton pencil beams using OSLD strips. We irradiated
OSLD strips positioned perpendicular to a proton pencil beam from
the scanning beam gantry at the PTCH. The results obtained with
OSLD strip agreed with the ionization chamber over orders of
magnitude (Fig. 5). The custom-build strip reader is still very
preliminary, but it demonstrates the potential of OSLDs for
measuring lateral profiles in proton therapy.
4. Conclusions
The results reviewed or presented in this work indicated that
OSLDs offer the capability of performing high-precision measure-
ments (experimental standard deviation of 0.7%) in radiotherapy
and show the possibility of one-dimensional dose mapping in
proton therapy and diagnostic radiology. In the case of diagnostic X-
rays, corrections for the over-response of Al2O3:C are necessary, but
good agreement with ionization chamber measurements were
obtained with proper calibration. In the case of proton beam
dosimetry, the energy dependence seems to be small for protons
above 100 MeV (within Æ2%), but the OSL response decreases at the
end of the proton range. It is important to mention that the results
are dependent on experimental conditions including choice of
detection filter and OSL signal (initial OSL intensity or total OSL
area).
Acknowledgements
The authors would like to thank Landauer Inc. for providing the
detectors used in this study, and Tammy Austin for proofreading
the manuscript.
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-5
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